# GRAYSTONE EYE SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093960395
- **Authorized official:** SHERRY B CALHOUN (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (828) 322-2050

## Contact information

- **Practice address:** 2424 CENTURY PL SE, HICKORY, NC 28602-4031
- **Practice address phone:** (828) 322-2050
- **Practice address fax:** (828) 345-0522
- **Mailing address:** PO BOX 3528, HICKORY, NC 28603-3528
- **Mailing address phone:** (828) 322-2050
- **Mailing address fax:** (828) 345-0522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | AS0036 | NC | Yes |

## Other

- **Enumeration date:** 12/01/2008
- **Last updated:** 08/20/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0062E | BCBS | NC |
| 01 | — | 1093960395 | AETNA | NC |
| 01 | — | 2924628 | CIGNA | NC |
| 05 | — | 3409979 | — | NC |
| 01 | — | NC81944 | WELLCARE | NC |